Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Monday, February 29, 2016

Weekly Australian Health IT Links – 29th February, 2016.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Dodgy State matters seem to have dominated matters this week - with patient privacy a major theme. All is not well in at least 2 States.
Other than that it now seems the NBN will be at least reasonable for the next few years until at least streaming 4K movies takes over in a few years’ time!
Enjoy browsing!
  • Feb 26 2016 at 5:13 PM

Pharmacists, doctors feud over 'botched' e-health record rollout

by Ben Potter
Pharmacists and doctors are feuding over the the federal government's struggling electronic My Health Record system.
The pharmacists' lobby chided doctors for failing to support My Health Record to help cut waste in the $155 billion healthcare sector. But the doctors' lobby said the system will not succeed in cutting waste because the rollout has been botched. 
"We have all got to be in it – it's either all in or none in," said George Tambassis, national president of the Pharmacy Guild of Australia. Health spending is being targeted by health minister Sussan Ley
Government data shows nearly half of medicines dispensed are wasted. Mr Tambassis said My Health Record could cut waste by identifying patients who were going to the doctor too often, doctor-shopping or pharmacy-shopping, doctors over-prescribing or pharmacies double-dispensing. 

Lack of expertise restricts e-health

Jennifer Foreshew

BIG e-health systems are prone to mistakes in the design stage because of a lack of expertise in the field, an expert says.
University of NSW's Centre for Health Informatics director Enrico Coiera said there was a "skills gap" in e-health despite it being so pervasive.
"We don't really have enough expertise available to help us make the right decisions," he said. "I think that is probably more of a problem in Australia than other countries."
Professor Coiera, who also directs the $2.5 million NHMRC Centre for Research Excellence in E-health, was speaking ahead of a Special Dean's Lecture he will give tomorrow at the University of Melbourne.

WA govt admits to "systemic" IT issues at Health department

Opposition calls for minister to resign.

By Allie Coyne
Feb 22 2016 12:44PM
The Western Australian government has admitted "systemic" IT issues plague the state's health department after an auditor-general's report detailed massive cost blowouts and mismanagement of the agency's centralised computing contract with Fujitsu.
Late last week the WA auditor-general revealed the four-year, $45 million contract had blown out by $81.4 million owing to a lack of proper oversight and controls.
The department is facing a potential corruption investigation over the issue after the case was referred to the state's Corruption and Crime Commission for investigation.
The Fujitsu deal was signed to provide primary and secondary data centres as well as ongoing management and support, but the auditor found the contract had been varied 79 times since it was signed in 2010.

WA Health avoids IT corruption inquiry, for now

But premier warns it could still eventuate.

By Allie Coyne
Feb 23 2016 11:47AM
The WA Corruption and Crime Commission has opted not to investigate the state health department's botched multi-million dollar IT contract with Fujitsu, but the state's premier has warned the department could still end up in front of the anti-corruption watchdog.
A damning report released last week by the WA auditor-general found the four-year, $45 million centralised computing contract had blown out by $81.4 million thanks to weaknesses in oversight and controls.
The audit office found the contract had been varied 79 times since its 2010 signing, with the department acquiring extra data centre equipment that it was unlikely to use.

Thirteen clinicians caught spying on medical records of Phil Walsh’s son Cy Walsh

February 23, 2016 5:35pm
Brad Crouch Medical Reporter The Advertiser
THIRTEEN clinicians have been disciplined for gaining unauthorised access into the medical records of Cy Walsh, charged with murder of his father and former Crows coach Phil Walsh last year.
The medical records, including toxicology results from Walsh’s hair are crucial to the trial.
Health Minister Jack Snelling and SA Health chief executive David Swan have both condemned the snooping — which could have consequences for the trial — and said the clinicians have been counselled for accessing the electronic records.
Walsh was taken to Flinders Medical Centre for tests following the death.

Health staff caught spying on Cy Walsh's medical records

Date February 23, 2016 - 11:22PM

Nick Toscano

Cy Walsh pleads not guilty

As reported in early February, son of slain Adelaide Crows coach Phil Walsh re-enters his not guilty plea, saying he was mentally incompetent the night his father was killed.
More than a dozen unauthorised medical staff have been caught accessing the confidential records of Cy Walsh after he was arrested over the murder of his father, former Adelaide Crows coach Phil Walsh.
His electronic records, including test results that could relate to the criminal trial, have been accessed by at least 13 health workers across South Australia in what authorities have called a serious privacy breach.

Doctors disciplined for snooping in patient records

AAP | 25 February, 2016 |
More than 20 medical staff have been caught snooping in patient files, including records related to the son of slain Adelaide Crows coach Phil Walsh.
Thirteen clinicians, including doctors and nurses, were formally disciplined after they inappropriately accessed the medical records of Cy Walsh following the death of his father last year.
Mr Walsh, 27, was taken to Flinders Medical Centre in Adelaide for tests following his father's death and was later charged with the 55-year-old's murder.
SA Health Minister Jack Snelling revealed on Wednesday that a further eight clinicians had been disciplined for inappropriately accessing the records of other patients over the past 12 months.

Patient privacy breach ‘is tip of the iceberg’: cancer patient

  • The Australian
  • February 26, 2016 12:00AM

Michael Owen

Cancer patient Andrew Knox has called for an independent judicial review into the South Australian government’s patient record management system, saying a fresh furore over serious privacy breaches is just the “tip of the iceberg”.
Mr Knox, 67, said yesterday his medical records relating to an incorrect chemotherapy dose may have been destroyed. “There’s not a single record that reflects the actual dose that I purportedly received ... some­thing’s not right,” he said yesterday. “The authority to give me prescriptions in the doses no longer exists ... there’s this cavalier attitude to records.”
More than 20 South Australian medical staff have been caught snooping on patient files, including records related to the son of Adelaide Crows coach Phil Walsh, who is charged with his father’s murder.

This app provides a handy guide to haematological conditions

24 February 2016
THE ASH pocket guide is released by the American Society of Hematology to provide information on a specific set of haematological conditions. 
The main menu offers a choice of topics. 
There are three guides on sickle cell disease including acute and chronic management of complications, as well as hydroxyurea and transfusion therapy. 
There are also three guides on thrombo­cytopenia covering heparin-induced thrombocytopenia, immune thrombo­cytopenia and thrombocytopenia in pregnancy. 
The single guides are to red cell transfusion, anticoagulant dosing and von Willebrand disease (VWD). 

How to improve the recording of patient refusals

24 February 2016
How to improve the recording of patients' refusal of or ineligibility for preventive services.
What's the issue?
The provision of preventive care is a major role and task for GPs, but some patients refuse one or more preventive services, and some patients some or all elements of preventive or other care are not indicated because of the patient’s clinical situation.
GPs need to document their patients’ refusal of or ineligibility for care for the purposes of good clinical care, maintaining good relationships with patients, accreditation* and protection against claims if adverse outcomes such as illness or an unwanted pregnancy occur because the patient did not receive relevant care. However, the clinical software packages marketed for use in Australian mostly provide no organised way of doing this, and to try to meet this need, GPs are creating their own workarounds which do not and cannot adequately serve the required purposes.

SA health minister rejects calls for e-health record privacy inquiry

Doctors caught accessing info on murder suspect.

By Paris Cowan
Feb 24 2016 5:04PM
South Australian health minister Jack Snelling has knocked back calls for an independent inquiry into the privacy of the state's e-health records, despite revelations 13 clinicians were caught abusing their privileges to access information on a murder suspect.
Cy Walsh was charged with the murder of his father, high-profile AFL coach Phil Walsh, last year.
Snelling told parliament this afternoon that a routine audit of user logs had exposed clinicians' unauthorised access to Walsh's information within the the state’s electronic medical records system.

E-health: A cautionary tale from a leader in the field

23 February 2016
As healthcare data becomes increasingly digitised, authorities are struggling to balance usability with privacy.
COMPARING international medical systems is like discussing whether apples, oranges or pears are best. But in the pioneering field of e-health, several key issues are universal:
  • Interoperability, that is, the ability of computer systems from different health sectors to communicate with each other
  • Privacy/patient identification
  • The ability to turn GPs’ freehand notes into meaningful data via codes.
E-health enthusiasts often cite Denmark as a gold standard for getting most of these right.
The Australian public/private system differs significantly from the entirely public systems of Scandinavia, and each has its historical, political and cultural quirks. 
But Denmark has several natural advantages. 
It has a small population in a small area (about 5.7 million people in 43,000km2, which is 0.6% the size of Australia).

Lambie spent $30k to keep records private

February 25, 2016
By Belinda MerhabAAP
Lambie spent $30k to keep records private
Independent senator Jacqui Lambie claims she was forced to spend $30,000 to keep her private medical records from being splashed across News Corp newspapers.
The former soldier told parliament a journalist from The Australian went on a fishing expedition to get access to her medical records following her long battle against Veterans' Affairs a decade ago for compensation.
She spent $30,000 fighting it and managed to redact details from the records after the Administrative Appeals Tribunal granted the journalist access.

The Clinical Terminology February v20160229 Release is now available for download

Created on Friday, 26 February 2016
The Clinical Terminology February v20160229 Release is now available for download from the NEHTA website.

Pitfalls of smartphone images in diagnosis

Nicole MacKee
Monday, 22 February, 2016
THE use of mobile phone cameras to capture radiological images from computer screens can lead to misleading information being conveyed and is of little use in the diagnostic process, a leading radiologist has warned.
Dr Greg Slater, president of the Royal Australian and New Zealand College of Radiologists, said a single-frame image transmitted by a mobile phone was not nearly as much help in the diagnostic process as it might seem.
“There is a lot of potential harm in this. [A single image] is a very limited part of the study, it’s transmitted in a non-private way, and it’s transmitted in a way that markedly reduces image quality. It can be misleading and can be missing a lot of diagnostic information,” Dr Slater told MJA InSight.

Cancer Support App Wins Health Industry Backing

A team of ambitious Sydney doctors have won crucial industry backing in their quest to raise the standard of doctor-patient communication in cancer hospitals.
Dr Nikhil Pooviah, Dr Raghav Murali-Ganesh and Dr Akshat Saxena have put their clinical careers on hold to develop an app that puts everything a cancer patient needs to know about their disease and treatment on their device. Patients can then easily share updates on their condition with family, friends and other treating doctors.
Called CancerAid, the project was selected from more than 300 applicants to receive business development funding and support through HCF’s Catalyst program. It is also keenly supported by Sydney’s world-class cancer treatment centre, the Chris O’Brien Lifehouse.
HCF Chief Executive Officer Shaun Larkin said: “As someone who has gone through the journey of cancer with a close family member, I can personally see exciting promise in CancerAid to deliver better outcomes for patients. We look forward to working with the team to make that promise a reality."

How far can medical 3D printing go?

Charlotte Mitchell
Monday, 22 February, 2016
EXPERTS are debating how widely 3D printing should be used in Australia, but they all agree that when the technology is used, it offers big benefits for doctors, patients and the health care system.
Dr George Dimitroulis, an oral and maxillofacial surgeon, told MJA InSight that “the sky is the limit for 3D printing because anything you can design on a computer, you can use”.

Infrastructure Australia and PriceWaterhouseCoopers weigh into the NBN debate: Paul Budde

February 22, 2016
Is the NBN a white elephant? Paul Budde
Both Infrastructure Australia and PriceWaterhouseCoopers (PwC) have now weighed into the NBN debate. They have looked at the value of the NBN in relation to the future sale of the company.
The eventual privatisation of the NBN is one of the few areas on which both sides of politics agree. That being the case then it would be prudent to build an NBN that maintains its value and will fetch a good price. Let’s say that it should at least cover the costs of the project at the time a sale is being considered. Because of the national interest it could be argued that simply covering the cost would be sufficient.
However building a potential white elephant in the form of the multi-technology mix is certainly not going to deliver on this. There is global consensus that eventually the majority of the national fixed telecoms networks will need to be based on FttH. In Australia the NBN company is not building such a future-proof network – quite the reverse – it is using out-of-date technologies with no plan as to how to move on from this version to a robust network fit for Australia’s interconnected economy. Those who eventually might buy the NBN will have to make a massive investment in getting rid of the MtM and replacing it with FttH, not something many potential buyers will be interested in.

nbn HFC achieves average trial speeds of 84Mbps

The National Broadband Network has achieved end-users average download speeds of 84/33Mbps with a pilot of its HFC network, drawing recognition from analyst firm Ovum that the upload speeds are among the fastest delivered over commercial HFC networks globally.
The nbn HFC trial was conducted at Redcliffe in Queensland with Retail Service Provider – Telstra, iiNet and Exetel  - delivering end-users speeds of up to 100Mbps download and 40Mbps upload.
nbn says it now has its sights set on launching commercial HFC services in June.

Sunday, February 28, 2016

The US And UK Governments Make It Clear What Is Needed For EHR Adoption. We Were / Are Not Even Close With The mHR.

The following report appeared a little while ago:
February 2016

The adoption and use of digital health and care record systems:

International success factors

A collaboration between NHS England and US Department of Health and Human Services

Here is the link to the report .pdf
The report outlines the following purpose and objectives:
Introduction and purpose
This publication sets out the findings of a collaborative work program undertaken between the US Department of Health and Human Services, NHS England and the Health and Social Care Information Centre; to investigate ‘what good looks like’ in terms of the successful adoption and optimization of digital care records for patients. While technology is evolving, particularly in terms of usability, this report focuses on the steps providers can take to ensure successful adoption and maximize technology utility. It is hoped that this report and its supplemental materials may be used by providers of care services to accelerate the adoption process, educate the workforce, and enable provider replication of best practices in order to mitigate common challenges.
Clearly such a study has some relevance to what is presently going on with the mHR.
The concluding section and what is needed for successful adoption is what matters:

6. Conclusion

The findings from this work program have been synthesised into a set of essential attributes which can be used by organisations to consider when embarking on a digital health transformation program. These are derived from the key learning points addressing cultural aspects, workflow design, and workforce competency and leadership qualities. All of these attributes require significant initial and on-going effort, often with delayed but ultimately positive results.
Our findings were clear in that there were a number of factors which were seen as pre-requisites (must have’s) and others which, although still essential, could not work without the former. For example, core standardised infrastructure was seen as one of the ‘must have’s’, whilst localised workflow design although extremely important, would not be possible without the other.
In piecing together these critical factors, a distinction between them was made; the ‘must do’s’ were labelled Primary Attributes, with the others being labelled as Secondary Attributes, yet all still being essential .
The synthesised findings are set out overleaf, which taken together with the accompanying toolkit comprising materials from both countries, can support both those who are early into their digital journey as well as those who are more advanced on their path to digital care records.

7. Essential attributes of successful adoption

Primary attributes
Need to be in place before the secondary attributes, and remain so throughout the development and continued use of the system.
a.> Ownership and inclusiveness needs to be felt by all staff, with support for patient care as the central focus of the deployment and genuine leadership commitment. This needs clear and regular communication across the whole workforce and transparency and realism around timelines and outcomes. A culture of trust should be developed throughout the development and continued use of the system. Consider the needs of patients, engaging with them as well as clinical and administrative staff. Take time to pause, and get it right.
b.> A solid core standardised and reliable infrastructure is imperative (i.e. networks and databases) which is able to support clinical and reporting requirements. Standardised, secure, uniform interfaces, reports, and templates across the organisation are important to ensure consistency in information aggregation and reporting. Local customisation has proved to be key to successful adoption.
c.> Establish and maintain a strong working relationship with the vendor/ supplier. Work together to establish a fair contract and ensure the product meets organization and/or practice needs, ensures accessible interoperability, and identify opportunities such as participating in user groups to both learn and provide feedback to vendor/supplier to influence and inform future developments.
d.> Interoperability with other systems is imperative. Patient information must be able to flow freely among patients and providers alike, enabling them to securely send, receive, find, and use the right information at the right time.
Secondary attributes
These need to be met through mobilising the primary attributes in order to continue to successful adoption.
a.> System workflow design should be a top priority and follow intuitive care pathways where possible. It should encourage patient engagement with their record and offer efficient, flexible and relevant data input solutions. The ability to customise and adapt the solution to local requirements has been found to overcome barriers to use.
b.> Training should be continuous. A core set of competencies is a must and should include information input, retrieval skills, security, confidentiality and quality management; with some knowledge of project and benefits lifecycles.
c.> Extra skill-sets should be identified and invested in according to clinical level of use. This will help with the retention of local expertise and key roles.
d.> Local expertise and key roles need to be retained, achieving a stable and motivated workforce.
e.> Easy access and effective use of other health IT technology, including mobile technologies, should be an important part of digital strategy. Use of hand held devices, barcodes, RFID, voice recognition etc.
----- End Extract.
From alienation of the private sector, lack of training on to totally ignoring workflow consequences on GPs it is clear you would have to mark the PCEHR a fail on pretty much all criteria.
I reckon we all know why our DoH and NEHTA were not consulted on this - even though one of our academics is cited. Of course the Department / NEHTA just ignored him as best as I can tell!

AusHealthIT Poll Number 309 – Results – 28th February, 2016.

Here are the results of the poll.

Do Politicians And Bureaucracies Understand Just How Hard And Complex Successful Delivery Of E-Health Is?

Yes 1% (1)

No 97% (129)

I Have No Idea 2% (3)

Total votes: 133

A really decisive poll. It seems most reading here don’t think the powers that be understand what they are attempting.

Great turnout of votes!

Again, many, many thanks to all those that voted!


Saturday, February 27, 2016

Weekly Overseas Health IT Links - 27th February, 2016.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

Failing to protect your mobile network: The cost for hospitals

January 29, 2016 | By Joanne Finnegan
The following is an excerpt from an article published in the FierceHealthIT's eBook "Best Practices for Securing Your Mobile Network." Download the eBook here to read more.
When it comes to protecting your mobile network, you can either pay now ... or pay later.
It's not an inexpensive proposition to pony up for security measures. But a failure to spend money up front to protect patients' protected health information (PHI) can potentially cost an organization millions of dollars down the line.
Just ask John Halamka, chief information officer for Beth Israel Deaconess Medical Center, a 631-bed teaching hospital in Boston. Each of his facility's reportable privacy breaches has cost more than a million dollars and has involved a single stolen mobile device, he says.

Sharing Notes with Patients Boosts Engagement

Alexandra Wilson Pecci, for HealthLeaders Media , February 19, 2016

A two-year OpenNotes trial led researchers to a conclusion about transparency: "If you think patient engagement is important to your health system," then sharing the providers' notes "is a no-brainer."

Between 40% and 80% of what a healthcare provider tells patients is immediately forgotten, and half of what they do remember, they get wrong.
"Those are two of the most depressing statistics I've ever heard," says John Mafi, MD, a professor at the David Geffen School of Medicine at UCLA. "We have a big communication problem in our healthcare system, and that's an understatement."
The result of all this miscommunication and forgetfulness, Mafi says, are the very things that are plaguing the healthcare system as a whole: Low patient engagement, poorly managed chronic conditions, prescriptions that go unfilled, medications that lay forgotten in medicine cabinets, bad outcomes, and high costs.

Tech support the Achilles heel for EHR implementations

Published February 17 2016, 2:29pm EST
As electronic health records become more widely used in the healthcare industry, providers are changing how they make decisions on which application to use.
For an increasing number, technical support will be an important differentiating factor.
And more providers are not happy with the service they are getting now, according to a recent survey from Black Book, a market research firm that regularly studies vendor satisfaction across several industries.

EHR research: We're entering uncharted, exciting territory

February 17, 2016 | By Marla Durben Hirsch
That said, there's no denying the inroads they're making in research. Recent reports we highlight this week really highlight EHRs' potential to delve into new, and frankly incredible, areas of education.
It worked. The researchers are so confident in their screening tool that they predict using it would identify an additional 400,000 people with active, untreated diabetes. And since 25 percent of Type 2 diabetes patients in this country are undiagnosed due to inadequate screening, this development can have a huge impact on treatment, population health and the cost of healthcare. We've known that EHRs help support the treatment of diabetes; this breakthrough takes such involvement one step further.
What's more, the screening algorithm that the researchers developed also uncovered several previously unknown risk factors for diabetes, many of which seem pretty random, such as a history of sexual and gender identity disorders, Colitis and Chicken Pox. And some of these newly identified risk factors are better risk factors than a few of the ones for diabetes that we're familiar with, such as body mass index or high cholesterol.

Researchers: Medical interns spent up to 7 hours a day using EHRs

February 15, 2016 | By Marla Durben Hirsch
Medical interns spent as much as seven hours a day on electronic health records and clocked an additional five hours a day on them even after they got used to the systems, according to a small study published in the Journal of Graduate Medical Education.
The researchers, from New York Methodist Hospital and St. Georges University School of Medicine in Granada, used a built-in tracking program to objectively quantify the EHR usage data of all 41 first-year internal medicine residents in a single program, using audit logs for May, July and October 2014, as well as January 2015. They tracked only active EHR use, defined as an electronic patient record encounter, which included chart review, orders, chart documentation and other activities, such as communicating with other providers via the EHR.
The researchers found that the interns spent an average of seven hours a day in active EHR use in July, when first starting to use the system. By January, the time had dropped, but still amounted to roughly five hours a day. The average number of minutes per electronic patient record encounter dropped from 41 minutes in July to 30 minutes in January. The researchers surmised that the numbers decreased as the interns became more familiar with the systems, improved efficiencies, and other factors.   

EHRs may help prevent in-hospital adverse events

February 16, 2016 | By Marla Durben Hirsch
Hospitals using a "fully electronic EHR"--a system "in which all physician notes, nursing assessments, problem lists, medication lists, discharge summaries and provider orders are electronically" developed--recorded lower incidences of in-hospital adverse events, according to a new study in the Journal of Patient Safety.
The study, sponsored by the Agency for Healthcare Research and Quality (AHRQ), examined EHR adoption and occurrence rates of patient safety adverse events by analyzing patient discharges, using data from the 2012 and 2013 Medicare Patient Safety Monitoring system. The authors looked at patients 18 years of age or older who were hospitalized for acute cardiovascular disease, pneumonia or conditions requiring surgery.
The outcome measures were in-hospital adverse events, including hospital acquired infections, adverse drug events, general events and post-procedural events. The study sample included 45,235 patients at risk for 347,281 adverse events at 1,351 hospitals
The researchers found that patient exposure to a hospital with a fully electronic EHR correlated with 17 to 30 percent lower odds of having an in-hospital adverse event. For example, such patients who were hospitalized for pneumonia had 35 percent lower odds of an adverse drug event and 34 percent lower odds of a hospital acquired infection.

IT managers are hacking their own systems, even in healthcare, survey finds

The Absolute report also showed that 65 percent of IT decision makers believe they would lose their job in the event of a breach.
February 18, 2016 03:21 PM
A high percentage of IT workers admit to not following the same security protocols they are expected to enforce, according to a new survey conducted across the United States by Absolute, a Canadian security firm.
In fact, 33 percent admitted to successfully hacking their own or another organization and 45 percent admitted to knowingly circumventing their own organization's security policies.
"The big surprise for us in this survey is that the gatekeepers are really the gatecrashers," said Stephen Midgley, vice president of global marketing for Absolute. Moreover, he said, while the survey of IT department managers included several industries, the findings apply across the board, with healthcare no exception.

CDS applications, natural language processing help reduce mortality rates for heart failure patients

February 18, 2016 | By Katie Dvorak
Clinical decision support applications that use natural language processing to identify heart failure (HF) patients and calculate readmission risk helped reduce 30-day mortality while improving discharge rates, according to a study published online in the Journal of the American Medical Informatics Association (JAMIA).
The researchers, from Intermountain Healthcare and the University of Utah, were able to identify HF patients earlier by using natural processing, and with that information--as well as data from the electronic health record--created a predicative score of the risk for each patient to be readmitted within 30 days.
Once the patients with HF risk and readmission risk were identified, the researchers were able to track the patients' care through a multidisciplinary care process pathway (CPP).

IBM to acquire Truven Health Analytics for $2.6B to bolster Watson Health

February 18, 2016 | By Dan Bowman
IBM aims to improve the capabilities of its Watson Health system by acquiring Ann Arbor, Michigan-based Truven Health Analytics, it announced Thursday.
IBM will pay $2.6 billion for Truven, a health data analytics company that counts federal and state government agencies, hospitals and health plans among its 8,500 clients. Truven's "technology, methodologies and health claims data will be integrated into the Watson Health Cloud over time," the announcement notes.

Publishing BI data improves hospital performance

Rebecca McBeth
16 February 2016
Publishing regular comparative performance data has driven significant clinical operational and financial improvements at a Gateshead trust, its chief clinical information officer has said.
Gateshead Health NHS Foundation Trust has used a business intelligence tool from System C to create a suite of reports and dashboards, including the quality and speed of discharges sent to GPs and results acknowledgement.
These are available to other System C users via a newly launched tool called Medway BI Data Visualisation, which is based on software from Yellowfin.

Hospitals need to get to grips with IT - Nuffield report

Lyn Whitfield
17 February 2016
NHS hospital boards need to get to grips with the potential benefits and pitfalls of implementing information technology, a new report from the Nuffield Trust urges.
‘Delivering the Benefits of Digital Healthcare’ identifies seven areas in which the think-tank argues that there are systems available that could deliver “huge scope from major improvements in quality and productivity.”
But it also warns that “without careful implementation” such technologies can “create inefficiencies, staff frustration, and even threaten quality of care.”

Ransomware Hits Hospitals

$3.6 Million in Bitcoins Demanded from Hollywood Hospital Mathew J. Schwartz (euroinfosec) • February 16, 2016    
A string of hospitals around the world - from Hollywood to Germany - have been hit recently by ransomware attacks, in a reminder that no organization is immune to outbreaks of malware that's designed to forcibly encrypt all data stored on PCs and servers (see Ransomware: Are We in Denial?).
One of the most severe cases involves Hollywood Presbyterian Medical Center, based in Los Angeles, which declared an "internal emergency" after staff noticed an apparent ransomware outbreak begin on Feb. 5, reports NBC. The attackers have demanded 9,000 bitcoins, currently worth about $3.6 million, reports Fox News.
The hospital couldn't immediately be reached for comment. But as of Feb. 12, multiple patients had been transferred to other hospitals as a result of the attack, electronic patient records remained inaccessible, and all hospital departments - lacking email access - were attempting to communicate via "jammed fax lines," NBC reports.

Hackensack University follows FHIR-enabled route to data exchange

Published February 17 2016, 5:32am EST
After his daughter suffered a concussion last year, Shafiq Rab, MD, CIO at Hackensack University Medical Center, saw how a lack of coordination and data exchange complicates the patient experience. “We had to go to the primary care physician, a neurologist, a vision doctor, a physical therapist—and I became the care coordinator,” he says.
The frustrating experience intensified Rab’s desire to use technology to improve healthcare delivery, helping patients and caregivers seamlessly connect and share information whenever and wherever they need to.
Toward this end, Rab and his team just released a Hackensack University app, which enables patients to make appointments with participating physicians, fill out forms, and access test results—all on their handheld phones or devices.

EHR data provides a trove of insights into diabetes

Published February 17 2016, 5:23am EST
A nationwide analysis of the electronic health records for nearly 10,000 patients by UCLA researchers has uncovered several previously unknown risk factors for Type 2 diabetes, including sexual and gender disorders, intestinal infections and some sexually transmitted diseases.
Using a newly developed screening algorithm and 9,948 electronic records gathered from hospitals, clinics and doctors’ offices in all 50 states, the research team was able to improve screening for the disease by predicting the likelihood of an individual having the disease and then successfully testing the pre-screening tool.
In the process, they believe they have developed a more accurate and less expensive way to identify patients who have undiagnosed Type 2 diabetes.

Hollywood Presbyterian hack signals more ransomware attacks to come

Experts says cybercriminals favor these types of attacks because they are reasonably easy to pull off and have a big impact.
February 17, 2016 01:41 PM
As hackers hold Hollywood Presbyterian Medical Center’s data and demand $3.4 million Bitcoin to give it back, experts say the “hostage situation” likely signals more ransomware attacks to come.
“There is no style to this attack,” said Kevin Johnson, CEO of firm Secure Ideas. Johnson said that it was likely messaging-based, whether a malicious link in an email or perpetrated via a social network and, basically, an employee fell for it.
Such attacks are particularly alluring to cybercriminals, in fact, because they are reasonably easy to pull off and have a big impact. 

Docs: Why the time for 'precision delivery' is now

February 17, 2016 | By Katie Dvorak
The healthcare industry must catch up with other sectors by using predictive data analytics at scale to improve clinical practice and care delivery, according to doctors at Brigham and Women's Hospital in Boston.
Providers must use patients' electronic health data to move into "precision delivery," Ravi B. Parikh, M.D., Meetali Kakad, M.D., and David W. Bates, M.D., write in a viewpoint published in the Journal of the American Medical Association.
There are already some instances where healthcare systems are starting to successfully implement analytics into practice, they write. Some examples they highlight include:
  • Lowering readmissions: At Parkland Health and Hospital System in Dallas, an algorithm created using clinical data and social and behavioral information was used to predict the probability of patients with heart failure being readmitted. By knowing which patients were most at risk, the health system was able to provide them with interventions such as education and follow-up communication on medication adherence. For those who participated in the interventions, there was a 26 percent reduction in odds of readmission, according to the viewpoint's authors.
  • Improving care for patients with serious illnesses: Analytics were used by the Veterans Health Administration to improve care quality for patients with serious illnesses. The VHA used its Corporate Data Warehouse (CDW), which stores patient data from across the department. The CDW calculated risk scores for patients that predicted hospitalization and death, and those scores help nurse care managers to guide services.

The endless possibilities of information and technology for improving health

Mary Toppings
Feb 16, 2016
Patients are not singular problems. Health care largely takes place outside of the office visit bubble, where complex humans carve out paths through everyday life. It occurs when parents, caregivers, second shift and working professionals make decisions like food choices and tradeoffs like exercise versus family time or overtime to pad a paycheck.
By enabling new care delivery methods, technology such as video visits is nudging provider awareness closer to that patient reality and feeding a growing knowledge base for providers. Combining that new information with technologies for care collaboration produces endless possibilities for improving health. Leaders face the challenge of supporting and identifying those innovations that best suit an organization and its customers, as well as implementing them.
Dr. Bill Marsh knows how leadership fosters innovation. Now Associate Executive Director of Care Delivery IT for The Permanente Federation, in a previous role with the Colorado Permanente Medical Group Dr. Marsh co-chaired a workgroup tasked with hatching new virtual care capabilities, including mobile applications, telemedicine and telehealth.

HIPAA and mHealth: OCR unveils new guidance on role of developers

February 16, 2016 | By Katie Dvorak
The federal government is continuing its push to help those in the healthcare industry better understand HIPAA regulations--most recently releasing guidance focusing on mHealth.
The new guidance examines six scenarios overall focusing on two questions that deal with health apps and HIPAA:
  • How does HIPAA apply to health information that a patient creates, manages or organizes through the use of a health app?
  • When might an app developer need to comply with the HIPAA Rules?
The scenarios provided address whether an app developer would be considered a HIPAA business associate (BA). However, the report's authors add that covered entities that transmit private health information also must apply safeguards.

In study, CBT app MoodHacker matches web-based programs for depression care

February 16, 2016
A cognitive behavioral therapy-based mobile app can be effective in treating depression symptoms, but is more effective in combination with an employee assistance program, according to a new study by Orcas of their MoodHacker app.
"To date, very few randomized clinical trials of mobile apps targeting depression and emotional well-being have been published in the peer-reviewed literature," Michael Mulvihill, CEO of Orcas, said in a statement. "We're excited to be contributing to the mobile health research community. The results of the study tell us we're moving in the right direction."
Orcas, which originally stood for Oregon Center for Applied Science, was founded in 1989 as a research organization looking into ways people could use technology to improve their own health. The organization has developed a number of mobile health apps and other interventions with funding from the National Institutes of Health. It transitioned in 2013 from a government-funded research group to a commercial company, offering their clinically validated apps as B2B products for employers.

OSU Wexner Medical Center masters change during award-winning IT effort

Published February 16 2016, 5:45am EST
Ohio State University Wexner Medical Center (OSUWMC) has plenty of experience implementing technology. After all, it’s the first two-time winner of the HIMSS Davies Award.
Managing the changes that technology brings about also requires significant commitment and effort, the organization has found. It’s also worked hard to manage the change that information technology brings to a staff.
Enabling change management is no small taks at OSUWMC, which serves all patients and populations, with the uninsured and Medicaid population comprising approximately 25 percent of the organization’s patient mix. It has six hospitals with 1,300 beds, a staff of 20,000, and more than 58,000 admissions per year, with 1.66 million outpatient visits.

Black Book: Tech support from EHR vendors essential as many hospital clients vent frustrations

IT support is emerging as a key factor in hospital satisfaction and many trends will shape these relationships, report says.
February 16, 2016 04:35 PM
Electronic health record vendors that don't offer robust customer technical support services risk losing established clients and new customers, according to a new report from Black Book Market Research that found that one-third of hospitals surveyed are currently unhappy with their IT support.
More than 82 percent of hospitals say tech support, whether from the vendor itself or from an outsourced partnering firm, will be a leading competitive differentiator in 2016, according to Black Book.
Tech support outsourcing is expanding, the survey data shows, with 16 percent of hospital respondents outsourcing at least half of their IT support needs. By the end this year, some 35 percent of hospitals with more than 100 beds expect to increase spending on outsourced support by 100 percent.

Hollywood hospital held to ransom by hackers

Image copyright HPMC Image caption Staff at the Hollywood Presbyterian Medical Center are using pen and paper to handle records
Ransomware is a growing menace for computer users - but when a hospital is targeted, it makes the disruption far more serious.
Computer systems at Hollywood Presbyterian Medical Center have been offline for more than a week following a ransomware attack.

From Meaningful Use to Meaningful Outcomes

February 15, 2016
by Marc Probst, CIO and vice president, Intermountain Healthcare
The federal government recently announced that its mandate for health information technology will move in a different direction. The change represents a vital opportunity that could lead to dramatic improvements in health care delivery.
Andy Slavitt, Acting Administrator of the U.S. Centers for Medicare and Medicaid Services (CMS), made the announcement on January 11th when he said at the J.P. Morgan Annual Health Care Conference, “The Meaningful Use program as it has existed will now be effectively over and replaced with something better… the focus will move away from rewarding providers for the use of technology and towards the outcome they achieve with their patients… And finally, we are deadly serious about interoperability.”
The distinction that Andy Slavitt makes—between functionality and outcomes—is crucial to the future and extraordinary potential of health IT. So is the need for interoperability.

ONC: Time to Get Busy with Value-based Payment Models

Scott Mace, for HealthLeaders Media , February 16, 2016

"We're in a little bit of a we-don't-know-what-we-don't-know state as an industry. And it's going to dawn on people really quickly that MACRA is a really big deal," says a co-chair of ONC's Health IT Standards Committee.

With a new year comes new leadership at ONC's Health IT Standards Committee. One of the recently appointed co-chairs of the committee is Arien Malec, vice president for the data platform solution line at RelayHealth. Last week I asked Malec what to expect from the committee in 2016. The transcript below has been lightly edited.
HealthLeaders: We had a lot of rulemaking at the end of last year, we had some spin put on the rulemaking by people like Andy Slavitt in January. So what is the industry thinking about meaningful use itself, and about stage 3 in particular?
Malec: The joking statement that I've done on Twitter is to keep calm and await MACRA-enabling regulation. Meaningful use is indelibly written in the ink of MACRA. It is indelibly written into the MIPS calculation, as 25% of the overall MIPS score.

Jane Sarasohn-Kahn: Health economist and trend weaver

"Health is where we live, work, play and pray. It's really everybody's responsibility."
March 25, 2015 12:03 PM
Jane Sarasohn-Kahn is passionate about collecting and constructing LEGO bricks because she truly embraces the Danish phrase from which the brand derived its name: 'leg godt,' meaning 'play well.'
In a playful mix of business and art, Sarasohn-Kahn clips her favorite publications (Rolling Stone, The Economist, Financial Times, The Wall Street Journal, The New Yorker) and adds fabric to create mixed media collages.
But scrapbooking isn't just what she does, it's how this trend weaver thinks: "I see health everywhere, at the grocery store, in the car — it's just my lens on things. And then I look at the economics and at the market."

HHS Plans to Strengthen Adult Immunization Health IT Infrastructure

February 12, 2016
by Heather Landi
The U.S. Department of Health and Human Services (HHS) plans to improve adult vaccination rates through its National Adult Immunization Plan, which includes plans to improve the health IT infrastructure behind adult immunization registries.
In a press release announcing the new National Adult Immunization Plan (NAIP), HHS officials cited Centers for Disease Control and Prevention (CDC) data that indicates 80 percent of adults ages 19 and older have not received recommended vaccinations to protect them against tetanus, diphtheria and pertussis (whooping cough) and more than 70 percent of adults ages 60 and older have not received recommended shingles vaccinations.